Abortion Stigma Among Low-Income Women Obtaining Abortions in Western Pennsylvania: A Qualitative Assessment

Amanda Gelman, University of Colorado, Aurora Elian A. Rosenfeld, VA Pittsburgh Healthcare System Cara Nikolajski, University of Pittsburgh School of Medicine Lori R. Freedman, University of California, San Francisco Julia R. Steinberg, University of Maryland, College Park Sonya Borrero, University of Pittsburgh School of Medicine

First published online:

| DOI: https://doi.org/10.1363/psrh.12014
Abstract / Summary

Abortion stigma may cause psychological distress in women who are considering having an abortion or have had one. This phenomenon has been relatively underexplored in low-income women, who may already be at an increased risk for poor abortion-related outcomes because of difficulties accessing timely and safe abortion services.


A qualitative study conducted between 2010 and 2013 used semistructured interviews to explore pregnancy intentions among low-income women recruited from six reproductive health clinics in Western Pennsylvania. Transcripts from interviews with 19 participants who were planning to terminate a pregnancy or had had an abortion in the last two weeks were examined through content analysis to identify the range of attitudes they encountered that could contribute to or reflect abortion stigma, the sources of these attitudes and women's responses to them.


Women commonly reported that partners, family members and they themselves held antiabortion attitudes. Such attitudes communicated that abortion is morally reprehensible, a rejection of motherhood, rare and thus potentially deviant, detrimental to future fertility and an irresponsible choice. Women reacted to external and internal negative attitudes by distinguishing themselves from other women who obtain abortions, experiencing negative emotions, and concealing or delaying their abortions.


Women's reactions to antiabortion attitudes may perpetuate abortion stigma. Further research is needed to inform interventions to address abortion stigma and improve women's abortion experiences.

Author's Affiliations

Amanda Gelman is resident in internal medicine, University of Colorado, Aurora. Elian A. Rosenfeld is postdoctoral fellow of women's health, VA Pittsburgh Healthcare System. Cara Nikolajski is research coordinator, Center for Research on Health Care, Department of General Internal Medicine, University of Pittsburgh School of Medicine. Lori R. Freedman is assistant professor, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco. Julia R. Steinberg is assistant professor, Department of Family Science, School of Public Health, University of Maryland, College Park. Sonya Borrero is associate professor of medicine and clinical and translational science, University of Pittsburgh School of Medicine.


The views expressed in this publication do not necessarily reflect those of the Guttmacher Institute.